SIBO Treatment, Symptoms, Diet & Causes
SIBO stands for small intestinal bacterial overgrowth and is defined as excessive bacteria presence in the small intestine. Under normal circumstances most of the bacteria in your gut live in the large intestine. The small intestine is the place where most of the nutrients get absorbed. It’s a relatively clean space with a very small amount of bacteria, due to the limiting auction of the digestive enzymes, gastric acid, bile and intestinal contractions. When intestinal function is impaired, bacteria can grow in the small intestine and lead to SIBO.
SIBO affects the integrity of the intestinal lining, leading to increased permeability and allowing more bacterial toxins to be absorbed in the blood stream. Typical symptoms include indigestion, bloating, gas, flatulence and pain after meals, constipation or loose stools, lack of energy. It has been linked to obesity (mild SIBO) or malnutrition (severe cases), nutritional deficiencies as fat soluble vitamins and iron, fibromyalgia, chronic fatigue syndrome, restless leg syndrome, acne, joint pain, rosacea and many more.
SIBO is associated with a wide array of conditions: diabetis, pancreatitis, decreased gastric acid, gluten free diet, aging that leads to decreased motility allowing bacterial reflux from the large intestine, alcohol and other toxins affecting the small intestine lining, post gastric bypass surgery or other abdominal surgeries, as well as other digestive inflammatory illnesses as Chron’s disease.
Diagnosis is made by breath tests, blood test or tissue biopsy.
Understanding the primary cause is paramount for treatment. Although the gold standard treatment in the medical practice remains antibiotics as Metronidazole or Rifaximin, they can create collaterally damage to the colonic flora that is beneficial to the body. However this can be only a temporary measure as SIBO tends to reoccur if the root causes are not addressed. Some herbal supplements as oregano oil can suppress bacterial growth. Other studies mentioned lemon balm oil, Indian barberry root extract, wormwood oil, berberine extract.
A healthy diet, nutritional supplements and lifestyle changes are necessary to get the body back in balance. Smaller meals to avoid food sitting for too long in the stomach and avoiding antacid medication.
Probiotics, probiotic foods and SIBO diet are a cornerstone of therapy. On study found probiotics and SIBO diet more effective then antibiotics. (https://www.ncbi.nlm.nih.gov/pubmed/21381407)
SIBO diet is based on avoiding certain foods called FODMAP. This is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. High FODMAP foods have a lot of simple carbohydrates and sugar alcohols that do not get well absorbed in the gut and ferment providing a feast for these bacteria. Examples of foods high in FODMAPs include:
- Beans, Lentilss
- Dairy products
- Juices and products rich in fructoses
- Cabbage, Brussels sprouts, Broccoli, Soys
- Artificial sweeteners
A high protein diet based on wild fish, grass feed beef, free rage poultry and eggs can starve these bacteria. Some fruits as fresh pineapple rich in bromelain ( anti-inflammatory) , tomatoes, grapes, blueberries are allowed. Other foods that could be consumed are quinoa, cucumbers, squash, carrots, leafy greens, almond milk. Probiotic rich foods are kimchi, sauerkraut, combucha, goat milk kefir, home made pickles (unpasteurized) other cultured vegetables.